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Workers' Compensation Program Specialists' Responsibilities



The Workers' Compensation Program Specialist is the bureau's designated point of contact for processing and managing data necessary for complying with bureau and Office of Workers' Compensation Programs (OWCP) requirements for workers with occupational injuries or illness. The Workers' Compensation Program (WCP) Specialist is responsible for:

Filing Claims:

  • The WCP Specialist ensures that injured employees complete claim forms in the Safety Management Information System (SMIS), if available.

    If the injured employee does not have access to SMIS, the WCP Specialist should allow the injured employee to use his/her computer or other available office computer; or, provide injured employees with paper copies of appropriate claim forms.

Timely Submission of Claim Forms:

  • When employee's completed CA-1, Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation or CA-2, Federal Employee's Notice of Occupational Disease and Claim for Compensation, is completed, check to see if form is complete.

  • Submit form in a timely manner - within 14 calendar days of employee's signature.

  • Ensure medical evidence is submitted within 10 workdays from date employee claims Continuation of Pay (COP) or the disability begins or recurs, whichever is later.

Tracking:

  • Upon SMIS notification of injury claim filed, follow-up with supervisor, offer assistance, and ensure that supervisor completes his/her section of the claim form in a timely manner.

  • Upon SMIS notification of claim filed, notify the bureau/office equivalent Safety Manager of employee's injury, either by e-mail or telephone.

  • Establish OWCP case file and maintain workers' compensation tracking log, case record form, or locally produced equivalents.

  • The Agency Query System provides access to information regarding an injured worker's compensation injury claims, such as payment of related medical bills.

Communication:

  • Provide employees and supervisors with information and assistance regarding workers' compensation.

  • Maintain personal contact with injured employee who is away from the workplace.

  • Coordinate with timekeeper to ensure that proper codes are entered on timesheets in order to track any Continuation of Pay and light duty hours.

  • Contact medical providers for updates on employee's work status and maintain information and records as necessary.

  • Serve as liaison between injured employees and the Department of Labor's OWCP, when appropriate.

  • Provide high-quality customer service.

Training:

  • Bureau/Office Equivalent Workers' Compensation Program Coordinators should train WCP Specialists in the field on how to complete the electronic filing of workers' compensation program claims.

  • Periodically evaluate training needs for bureau management, supervisors, and field WCP Specialists.

Controversion:

  • Assist supervisors in controversion of claims. Continuation of Pay (COP) is the continuation of regular pay by the bureau to an injured employee. There is no charge to sick leave or annual leave. The injured employee is entitled to up to 45 days of COP when:

    • A form CA-1, Notice of Traumatic Injury Claim form is filed within 30 days from the date of injury, and

    • The injured employee presents medical evidence to support disability within 10 calendar days.

Continuation of Pay (COP)

  • An agency's objection to paying Continuation of Pay (COP) for one of the 9 reasons provided by FECA regulation is called "controversion." It is the option of the employee's supervisor or designated agency workers' compensation program specialist and is used to dispute the injured workers' eligibility for COP entitlement. The supervisor may controvert a claim by completing the indicated portion of CA-1 and submitting detailed supporting information to OWCP. Even though a claim is controverted, the agency must continue the employee's regular pay unless at least one of nine reasons under FECA apply.

Accommodation:

  • Assist supervisors in providing injured employees with alternative work assignments or creating light duty or restricted duty assignments whenever possible for injured employees.